Provider Demographics
NPI:1174842959
Name:HUGHEY, WANITTA MARIE
Entity Type:Individual
Prefix:MS
First Name:WANITTA
Middle Name:MARIE
Last Name:HUGHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:WANITTA
Other - Middle Name:MARIE
Other - Last Name:SCHOETTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:709 WHIRLWIND DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-4559
Mailing Address - Country:US
Mailing Address - Phone:541-974-1650
Mailing Address - Fax:
Practice Address - Street 1:709 WHIRLWIND DR NE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-4559
Practice Address - Country:US
Practice Address - Phone:541-974-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200730076LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse